Basic Program Structure. With a capacity to serve up to 36 teens, Inwood House Maternity Residence is the largest of three New York City maternity homes for pregnant teens in the foster care system.2 The Administration for Children Services (ACS), the city's child welfare agency, contracts with Inwood House to operate the program, which serves pregnant young women under the age of 21 until the birth of their child. After their babies are born, residents and their babies must be placed with a foster family or in a group home for teen parents. Inwood House was founded in 1830 and opened its first maternity residence in 1847. It has been serving pregnant teens from the city's foster care system since the 1930s. In addition to its maternity residence, Inwood House operates several other programs to serve pregnant and parenting teens, as well as programs designed to reduce teen pregnancy.
Funding Sources and Levels. The Inwood House maternity home has an annual budget of about $1.7 million. These funds come primarily (91 percent) from ACS, which provides Inwood House with set monthly payments to cover the costs of their housing and support services. Most other funding for the program comes from Medicaid. In addition, the state provides Inwood House some TANF funding to cover case management services for the fathers of residents' babies. These government funds are supplemented with funding from private foundations. The average monthly costs per teen served by the program is about $6,000.
Eligibility Rules and Referral Sources. To be eligible, residents must be pregnant and in the foster care system. In addition, since ACS regulations prohibit babies from residing in facilities for pregnant teens in foster care, residents must not have custody of any other children. All referrals to the program come from ACS, and Inwood House is generally required to accept the referrals it receives. ACS requires all teens living in group homes (the most common setting for these teens) to transfer to a maternity residence if they become pregnant. In addition, many foster families hosting teens request that the teen be moved if she becomes pregnant. For this reason, most pregnant teens in the city's foster care system live either at Inwood House or one of the other two city maternity homes that serve foster care teens.
Setting and Structure of the Homes. Inwood House is located in a quiet residential neighborhood on New York's Upper East Side. The organization owns the six-story building and operates several programs out of the facility. Three of the floors are devoted to the maternity home and each of these floors has 12 rooms, one large bathroom, and a lounge. Because of low enrollment in the maternity residence in recent years, one of the residential floors is now used by other Inwood House programs. Residents all have their own bedrooms and share living rooms and dining areas.
Staffing Patterns. The Inwood House program serves a large number of teens, typically about 24 at a given time in recent years. Moreover, ACS regulations require 24-hour-awake staff, as well as a low resident-to-staff ratio. For these reasons, the program has a large staff of social workers, paraprofessionals, administrators, and support staff. The maternity residence is overseen by a director of residential services, assisted by a director of youth care who oversees the large staff (7 full-time and 12 part-time) of paraprofessionals who provide basic supervision and other services to residents. The home also employs two full-time social workers who provide case management services; a full-time independent living coordinator who provides life-skills training; a full-time registered nurse who coordinates residents' medical care and teaches child birth, child health, and nutrition classes; and a part-time clinical psychologist who provides group and individual therapy, as well as psychological testing, to residents. Inwood House also employs a job developer who provides career readiness training to residents and a housing specialist who assists young women aging out of foster care find appropriate housing. In addition, the program employs a full-time cook, three maintenance workers, and several other administrative and clerical staff.
Core Program Services. The Inwood House maternity home offers a wide array of support services. Residents are required to participate in six weekly one-hour classes on independent living skills, childbirth, infant care, health, substance abuse prevention, and other special topics. Residents are offered incentives for attending these sessions, including vouchers that can be used to purchase items for their baby at the program's “baby boutique.” Residents also have weekly meetings with their case managers to review their behavior, school performance, and other personal issues. Inwood House requires all residents to attend school full time if their health permits. The program offers an on-site school for teens who are unable to find an appropriate educational program in the community. This school, which is used by about one in four residents, provides daily class instruction and is taught by a certified New York City school teacher. Inwood House also operates the “Fathers Count” program for the fathers of the residents' babies. The program offers case management services to these young men, including referrals to job and education services, parenting classes, anger management groups, and legal assistance. Fathers are also encouraged to attend the childbirth and other classes Inwood House offers for its residents.